Directly Observed Therapy for Tuberculosis in New York City-Reply

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Abstract
In Reply. —The many public and private health care providers and outreach workers of New York State and NYC are to be congratulated for achieving a more than 10-fold increase in DOT for TB patients in NYC in just 2 years.1It is critical that this effort be sustained. While attributing any decline in secular trends to a specific intervention must be done cautiously, the role of DOT in the dramatic 15% decrease in reported TB cases from 1992 to 1993 (from 3811 to 3235) must be strongly considered. It will be important to further document their success by evaluating completion rates in patients with and without this intervention. At the same time, the use of DOT in NYC was not the only intervention. It was part of an individualized patient treatment plan that also provided accessible services, a reliable source of medication, treatment in a variety of settings,